Provider Demographics
NPI:1235365198
Name:JEFFREY MERKLE MD, LLC
Entity Type:Organization
Organization Name:JEFFREY MERKLE MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MERKLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-852-6400
Mailing Address - Street 1:254B MOUNTAIN AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2407
Mailing Address - Country:US
Mailing Address - Phone:908-852-6400
Mailing Address - Fax:908-852-6450
Practice Address - Street 1:254 MOUNTAIN AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2407
Practice Address - Country:US
Practice Address - Phone:908-852-6400
Practice Address - Fax:908-852-6450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07799200207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJBM9086768OtherDEA
NJBM9086768OtherDEA
NJBM9086768OtherDEA